IntroductionCirrhosis of liver is the twelfth leading cause of death in the world, killing thousands of people every year.

Basic pathology in the cirrhosis is the scarring of the liver tissue which is followed by fibrosis [formation of scar tissue] and destruction of the normal architecture of the liver. Cirrhosis is a complex process where inflammation, destruction (necrosis), fibrosis and regeneration are going on simultaneously. The liver cells that are functionally intact undergo hypertrophy to compensate the process of destruction. New hepatocytes are also formed in clusters that give rise to regenerative nodules within the scar tissue. This scar tissue is unable to carry out normal metabolic functions of liver which ultimately leads to the development of systemic manifestations. Loss of normal architecture also leads to abnormal communications between the portal and systemic vasculature within the liver.

Pattern of responseThe evolution of cirrhosis is gradual & progressive. Cirrhosis is a serious, chronic condition.

Causes of cirrhosisThe treatment modalities and miasmatic assessment depend upon the causes, clinical features and the extent of hepatic pathology.

Alcohol (50 %)

Viral infection (20 % )

Hepatitis B, C, D.

Non A-E viral hepatitis

Drugs, Toxins etc. (10 %)

Others(10%)·

Primary biliary cirrhosis

Sclerosing cholangitis

Blocked bile ducts

Veno-occlusive diseases

Budd-chiari syndrome

Nonalcoholic Steatohepatitis( NASH)

Inherited diseases

Clinical featuresIn early stages, hepatic cirrhosis may be asymptomatic. Even 10% of the healthy liver tissue is adequate to carry out the normal metabolic functions. Cirrhosis may take years to manifest itself clinically or before any clinical suspicion is aroused. Most common clinical features of cirrhosis are enlisted below.

Conclusion:The correlation between stages of cirrhosis and repertorial rubrics has been presented for the sake of clarity of miasmatic assessment. Although the person diagnosis and individualization are the central tenets of prescribing, the stages of cirrhosis and the therapeutical application of homoeopathic remedies should not be underestimated. It is important to make the totality of a case, a comprehensive diagnosis – person diagnosis + disease diagnosis for rational management of a serious condition like cirrhosis of liver.

(The gradation given to miasms – 3, 2, and 1 indicates the preponderance of miasmatic influence over the system. The gradation given to remedies concerning the rubrics is as per the intensity of remedies.)

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